Nephrology
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Conservative Dialysis Strategy Accelerates Kidney Recovery in Dialysis-Requiring AKI — Early Randomized Evidence from LIBERATE-D
The LIBERATE-D randomized trial found that a conservative, indication-triggered dialysis strategy increased unadjusted kidney-recovery rates at hospital discharge and shortened time to dialysis independence compared with routine thrice-week
When Cystatin C Says the Kidneys Are Worse: Discordant eGFR and High Risk — Findings from 860,000+ Patients
A CKD-PC individual-patient meta-analysis found that 11% of outpatients and 35% of inpatients had eGFR by cystatin C ≥30% lower than creatinine-based eGFR; this discordance predicted higher mortality, cardiovascular events, heart failure an
A‑E‑I‑O‑U and Sometimes Why—Dialysis in Acute Kidney Injury
LIBERATE‑D randomized hemodynamically stable patients with AKI to conservative vs conventional thrice‑weekly continuation of KRT; conservative discontinuation increased dialysis‑free recovery, shortened time to recovery, and reduced session
SGLT2 Inhibitors Protect Kidneys Across the Spectrum: Benefits Even in Stage 4 CKD and Minimal Albuminuria
A SMART‑C meta‑analysis of 70,361 participants shows SGLT2 inhibitors reduce CKD progression and kidney failure across eGFR and albuminuria strata, including stage 4 CKD and low albuminuria.
A 250‑ml Ultrafiltration Challenge Identifies Patients at Risk of Becoming Preload‑Dependent During CRRT
A randomized cross‑over trial found that a 250‑ml net ultrafiltration challenge reliably identified preload‑independent critically ill patients who became preload‑dependent during continuous renal replacement therapy; a ≥5% calibrated cardi
Rituximab Markedly Reduces Relapse in Adult Relapsing Nephrotic Syndrome: Randomized Trial Data from Japan
A multicenter randomized trial in Japan found that rituximab significantly increased 49‑week relapse‑free survival versus placebo in adults with frequently relapsing or steroid‑dependent nephrotic syndrome, though infusion reactions were co
Sodium Bicarbonate in Severe Metabolic Acidemia with AKI: No Survival Benefit but Less Dialysis — Insights from BICARICU-2
The BICARICU-2 randomized trial found that intravenous sodium bicarbonate in patients with severe metabolic acidemia and moderate-to-severe acute kidney injury did not reduce 90‑day mortality, but was associated with a substantial reduction
Choice of Vasopressor in Septic Shock: Does It Change Kidney Outcomes? A Critical Appraisal of the Evidence
A systematic review of 17 randomized trials (n=4,259) found no consistent renoprotective effect from any vasopressor in septic shock. Heterogeneous definitions, underpowered studies, and reliance on RRT limit conclusions; standardized renal
Adjunctive Terlipressin in Refractory Septic Shock: Lowers High-Dose Catecholamine Need at 6 Hours but No Mortality Benefit
In a double-blind RCT of 130 patients with refractory septic shock, terlipressin increased the proportion achieving MAP ≥65 mmHg with low catecholamine exposure at 6 hours versus placebo but did not change 28-day mortality; digital ischemia
Renal Contrast‑Enhanced Ultrasound Is Reproducible in Stable Critically Ill Patients — mTT Is the Most Robust Metric
In stable critically ill patients, contrast‑enhanced ultrasound (CEUS) renal perfusion metrics are reproducible; amplitude measures (RBV, PI) are more dose‑sensitive while mean transit time (mTT) shows greater robustness across infusion cha
Lactate Predicts Citrate Accumulation During Continuous Kidney Replacement Therapy: incidence, severity, and clinical implications
In 911 critically ill patients on RCA-CKRT, citrate accumulation occurred in 17%. Pre-CKRT lactate strongly predicted accumulation (OR 2.34 per 1-unit increase on log scale); VIS was less discriminatory. Accumulation linked to liver dysfunc
Urine‑guided Intraoperative Hydration Halves AKI Risk After CRS‑HIPEC with Cisplatin: Randomized Trial Shows Promise
A randomized trial found that maintaining high intraoperative urine output (≥3 ml·kg−1·h−1 or ≥200 ml·h−1) during cytoreductive surgery and cisplatin‑based HIPEC reduced 7‑day postoperative AKI from 39.3% to 21.4% and lowered major 30‑day c
Predicting Early Acute Kidney Injury After Liver Transplantation: A Clinically Useful 48‑Hour Risk Model
A single-center study developed and internally validated a 48‑hour post‑liver transplant AKI risk model using five readily available preoperative and intraoperative variables (HE, alcohol cirrhosis, ALBI ≥ −1.78, operation time ≥560 min, an
Evaluating Dapagliflozin’s Impact on Bone Health in Lupus Nephritis: Insights from a Double-Blind, Placebo-Controlled Trial
This RCT shows dapagliflozin does not significantly affect bone metabolism or mineral density in lupus nephritis patients over 12 months, alleviating concerns about SGLT2 inhibitors’ bone safety in this population.
Dapagliflozin and Cardiac Remodeling in Chronic Kidney Disease: New Evidence for Cardioprotection
Dapagliflozin reduces left ventricular mass index in chronic kidney disease patients, revealing a key mechanism for cardioprotective effects of SGLT2 inhibitors and highlighting early treatment benefits.
Environmental and Social Injustices Elevate Dementia Risk in Older Adults with End-Stage Kidney Disease: Insights from a National Registry Study
This national registry study reveals that older adults with end-stage kidney disease (ESKD) exposed to high fine particulate pollution and racial/ethnic segregation face significantly elevated dementia risk, highlighting critical environmen
Survival Benefits of Deceased Donor Kidney Transplant versus Waitlisting: Insights from a Population-Based Cohort Study
Deceased donor kidney transplantation improves survival compared to dialysis waitlisting, with benefits varying by donor kidney quality and recipient age. Low-risk kidneys yield the greatest survival gains, particularly in older recipients.
IXA Position Paper: Practical Roadmap for First-in-Human Porcine Kidney Xenotransplantation
The International Xenotransplantation Association (IXA) 2025 position paper offers evidence-based recommendations for initial clinical trials of genetically engineered porcine kidney transplants for end-stage renal disease, focusing on dono
Mitigating Risks of Donor-Derived Epstein-Barr Virus Infection in Pediatric Kidney Transplantation: Advances and Challenges
This article reviews recent studies on EBV transmission in pediatric kidney transplants, highlighting risk factors, monitoring strategies, and implications for reducing posttransplant lymphoproliferative disorder (PTLD).
FDA Approves Roche’s Obinutuzumab for Lupus Nephritis: Promising Advances in B-cell Targeted Therapy
The FDA has approved Roche’s obinutuzumab for active lupus nephritis in adults, offering a twice-yearly dosing regimen that achieved nearly 50% complete renal remission in trials, marking a significant advancement in lupus nephritis managem
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